What is Hypospadias? Understanding This Common Penile Abnormality

What is Hypospadias?

Hypospadias is a common congenital (present at birth) condition in boys where the opening of the urethra — the tube through which urine passes — is not at the tip of the penis where it should be. Instead, the opening (meatus) is located on the underside of the penis, at any point from just below the tip to the scrotum.

How Common Is It?

Hypospadias affects approximately 1 in every 200–300 male births, making it one of the most common birth defects in boys. It is more common than many parents realise.

Types of Hypospadias

• Distal (70%) — the opening is near the tip of the penis (easiest to treat)
• Mid-shaft (10%) — the opening is in the middle of the shaft
• Proximal (20%) — the opening is near the base of the penis or scrotum (more complex)

Associated Features

• Chordee — downward curvature of the penis (present in about 30% of cases)
• Incomplete foreskin — the foreskin develops differently, appearing hooded
• In severe cases — undescended testis or other urogenital abnormalities

When Is It Diagnosed?

Hypospadias is almost always diagnosed at birth during the routine newborn examination. Occasionally, it is detected prenatally on ultrasound. Parents should be reassured that this is a well-understood condition with excellent surgical outcomes.

Does It Need Treatment?

Yes — surgery is the recommended treatment for most cases of hypospadias. Surgery is done to:

• Move the urethral opening to the correct position at the tip of the penis
• Correct any curvature (chordee)
• Create a normal-appearing penis
• Allow the child to urinate standing
• Ensure normal sexual function in adulthood

When Is Surgery Done?

Surgery is typically performed between 6 months and 18 months of age. This timing is recommended because: anaesthesia is safer after 6 months, the baby is less aware of the procedure, and healing and tissue recovery are excellent at this age.

Surgical Outcomes

With experienced pediatric surgeons, hypospadias surgery has excellent outcomes. Success rates are above 85–90%. Most children lead completely normal lives after surgery with normal urinary and sexual function.